Cigarette smoking remains the single largest preventable cause of premature death and disability in the United States, and effective anti-smoking campaigns require innovative tobacco control efforts. The Family Smoking Prevention and Tobacco Control Act of 2009 represents such an effort, including its requirement that large, graphic health warning labels appear on tobacco packages. Research suggests that such graphic warning labels are effective in changing smoking-related attitudes, beliefs, and intentions. However, previous controlled studies that experimentally manipulate exposure to graphic warnings have been confined to the study of explicit measures and proxy behavior, and recent dual-process models and supporting data (including data from our current project) suggest that both implicit and explicit cognition are important determinants of smoking behavior. Our current grant DA 13555 Teen & Adult Smoking: Intergenerational Transmission and Prevention Applications has shown that implicit attitudes toward smoking predict both smoking initiation and smoking cessation. One of its major goals in the current project period is to test te effects of an anti-smoking public service announcement (along with approach-avoidance practice) on implicit attitudes toward smoking. The current proposal extends this aim to examine the effects of the FDA's graphic warning labels on implicit attitudes toward smoking, perceived likelihood of cigarette smoking and other tobacco use, and engagement with anti-smoking information. The proposed project will re-recruit a group of young adults (18-26) who were measured previously as adolescents (in 2004-2005) as part of a family socialization study. In a short-term (1 week) longitudinal web-based study, we will examine the effects of the FDA graphic images plus corresponding warning statements on implicit attitudes toward smoking (measured both before and after exposure), compared to warning statements only and images of other negative health behaviors. We will identify the specific underlying components of implicit attitudes that are changed by the FDA graphic warnings and test whether the effects of the graphic warnings vary for individuals at varying levels of pre-existing risk (measured in adolescence). The results will both provide information about the effects of the FDA warning labels and provide a methodology for investigating the effects of anti-smoking warning labels on implicit measures and underlying processes. PUBLIC HEALTH RELEVANCE: Because cigarette smoking is the single largest preventable cause of premature death and disability in the US, creating effective prevention and cessation interventions is an important public health goal. The data from the proposed study will advance understanding of the levels and modes of efficacy of the FDA's graphic tobacco warning labels in helping to limit or deter smoking.